Occupational accessory and suprascapular nerve palsy. A clinical and electrophysiological study
Cruz Martínez, A.; Ramírez, A.
Electromyography and Clinical Neurophysiology 28(6): 347-352
1988
ISSN/ISBN: 0301-150X PMID: 3248558 Document Number: 306080
Two cargo loaders developed accessory nerve palsy. In one patient the accessory neuropathy was associated with supracapsular nerve damage. In the case with isolated accessory neuropathy, the palsy occurred 5 years before admission. Despite the discomfort and weakness of the shoulder, the patient carried on his work. Physical therapy did not improve the clinical picture after 15 months. An earlier diagnosis was made in the patient with associated accessory and suprascapular neuropathies. Suppression of cargo loading and physical therapy resulted in a marked improvement. The electrophysiological study was helpful to define the affected nerves, type of neuropathy and level of the lesion. Electromyography and nerve conduction studies of affected and unaffected nerves were objective methods to evaluate the nerve damage when the follow-up studies were made, and also were helpful to exclude the possibility of a widespread subclinical neuropathy. Both neuropathies were related to the patient's occupation and their possible mechnaism are discussed. The main causes of both nerve lesions reported in the literature are summarized.